A doctor requests a laptop. It ends with her being suspended from the medical register. The case understandably caused outrage among her fellow professionals and the MDU stepped in to challenge the decision on her behalf.
For a dispute with an employer about a laptop to lead to a fitness to practise tribunal and suspension was both unfair and disproportionate, so I'm delighted that the GMC did not contest our appeal. It has also commissioned a review of the circumstances in the case. It is important that the GMC is ready to practise the same reflection it expects of doctors, and hopefully lessons will be learned.
It is always satisfying to achieve a good outcome for our members, especially when they have been so obviously the victim of injustice. At the same time, I think the case speaks volumes about the value of belonging to a mutual organisation that only exists to guide, support and defend the interests of members, rather than a group of shareholders.
Our mutuality defines us. It is not only our commitment to individual doctors and dentists who need advice or assistance - but it is the utilisation of a collective voice that we deploy on our members' behalf to positively influence the medico-legal issues of the day, from parliament to the GMC.
Over the last twelve months, the MDU has been working on members' behalf on a number of fronts. Here are three examples of where we are making your voice heard.
We were a lead advocate in a campaign to improve the Health and Social Care Bill so healthcare professionals would feel able to engage with investigations by the new Health Service Safety Investigations Body (HSSIB) and the 'safe spaces' it offers, without fear or blame. As originally laid before parliament, the bill gave coroners routine access to material held by the HSSIB, a provision which effectively set safe-spaces up to fail.
In March, the government listened to these concerns and agreed to amend the bill to exclude coroners from the safe space so doctors can speak freely to the HSSIB about what happened after a serious adverse incident. This small change represents a significant step towards an open, no blame culture in the NHS, where investigations lead to real advances in patient safety.
NHS claims liabilities are second only to nuclear decommissioning provisions in the Whole of Government Accounts for the year to March 2020.
On the issue of the unsustainable cost of clinical negligence litigation, the MDU's evidence to the Health and Social Care Select Committee was extensively quoted in its report in April, which painted a vivid picture of a system ripe for reform.
The MDU has long called for ambitious but deliverable reform of the system This is needed more urgently than ever following the revelation that £86 billion has now been reserved to cover the cost of clinical negligence claims against the NHS in the UK. NHS claims liabilities are second only to nuclear decommissioning provisions in the Whole of Government Accounts for the year to March 2020.
Given our expertise and experience in this area, I was pleased that we were able to contribute such compelling evidence. The time for action is now, and we are determined to continue making the case to the government, to ensure action is finally taken.
Finally, and bringing things right up to date, the MDU is carefully studying the GMC's latest proposed edition of 'Good medical practice', which has just been the subject of an extensive public consultation. This is the first substantial update since 2013, so the end product is likely to set the standards expected of doctors into the 2030s.
We have a number of concerns about the changes that the GMC is proposing. Many of those concerns are rooted in the fact that the new duties just do not seem to reflect the realities of doctors' daily working lives and hence set too high a bar, or they create duties which are highly subjective.
Our response to the GMC benefits from the combined insights of our medico-legal advisers and in-house legal team, who have unequalled experience of representing members during fitness to practise investigations and how 'Good medical practice' informs this process.
The MDU always has, and always will, argue energetically for changes at the GMC to make the fitness to practise processes fairer and less stressful for members. You can read more about the consultation in this issue.
As a mutual organisation, the MDU feels a duty to take a principled stand whenever we see - or foresee - injustice, whether that is engaging with the regulators, making the case for reform of outdated systems or trying to shape legislation that will impact members' working lives.
Our readiness to speak out on medico-legal matters that could be damaging to our members differentiates us from commercial insurers, and in doing so we can draw on the wisdom and experience of the doctors who work for the MDU and who serve on our council and board, such as our outgoing chair Paul Riordan-Eva.
But most importantly, we speak for more than 200,000 doctors and dentists who entered their profession to do their best for patients. That collective strength continues to make the MDU a principled force to be reckoned with. It is who we are, why we exist, and how we work.
Dr Matthew Lee
Chief executive, the Medical Defence Union
Dr Matthew Lee
Chief executive, the Medical Defence Union
BM, MBA, FRCP, MRCPCH, FFFLM
Matthew has been chief executive of the MDU since September 2021.
He has worked at the MDU since 2000, initially as a medico-legal adviser assisting members facing complaints, disciplinary procedures and criminal investigations before becoming professional services director (with responsibility for claims handling, underwriting, legal services and the medical and dental advisory services) in 2009.
He joined the MDU from a background of working as a clinical fellow in paediatric intensive care in Southampton, having trained in both anaesthetics and paediatric medicine.
See more by Dr Matthew Lee